Breastfeeding Questions and Challenges

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Breastfeeding FAQs


 

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While you don’t need to buy anything special to breastfeed your baby, it may help to have a few of these items:
  • Bras: A nursing or sports bra may make it easier to breastfeed. It may be helpful to purchase only one bra to start as your breast size changes in the first few weeks after birth.
  • Nursing pads: Pads soak up leaking breast milk, common in the early days. Change wet nursing pads often. Reusable pads are washable and less expensive than disposable ones.
  • Nipple cream: Sore nipples are common the first few days of breastfeeding. Apply expressed breast milk to affected area and allow to air dry to soothe skin. If soreness continues, there are a variety of nipple creams on the market.  Check the ingredients to ensure there are not irritating to you or your baby. If the recommendation on the bottle is to wash it off before breastfeeding, select a different cream. 
  • Pillow: A breastfeeding pillow or regular pillow may be helpful. Test out breastfeeding pillows before buying, as one size does not fit all. 

 
Breasts and nipples come in a variety of shapes and sizes. Small breasts can make just as much milk as larger breasts. Almost all breasts make milk.

Breast surgery may affect your milk supply. If you have had breast surgery, speak with your healthcare provider about milk production and your breasts.‎

 
Health Canada recommends breastfeeding babies receive liquid Vitamin D drops for the first 24 months of age (up to 2 years).  You can purchase liquid Vitamin D at your pharmacy.
  • Give your breastfed baby 400 IU (international units) of liquid Vitamin D supplement every day (a dose of liquid drops).
  • Start giving your baby Vitamin D as soon as possible after birth or as directed by your healthcare provider.
If your baby is breastfed and formula-fed, give your baby a daily Vitamin D supplement. 

Speak with your community nurse or healthcare provider if you have questions about Vitamin D supplements. 

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‎Things you can do to comfort your baby during minor tests and procedures like vaccine shots:

  • Hold your baby skin-to-skin before, during, and after a procedure when possible.  
  • Breastfeed your baby before, during, and after a procedure when possible.
  • Stay calm and speak to your baby in a soft, low voice.

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You don’t need to eat any special food when you are breastfeeding. It is unlikely that something you eat will affect your baby.  Nutritious food helps you stay healthy and gives you energy. 


Drink water regularly. Have a glass of water nearby when you are breastfeeding in case you get thirsty. 

Helpful links:

 

 

‎It’s best to limit your caffeine (coffee, tea) to 300 mg per day – about 1 ½ mugs of coffee while breastfeeding. Some babies are sensitive to caffeine and may become fussy or restless.

Drinks such as pop, energy and sports drinks, chocolate and over-the-counter medicines may contain caffeine and are also high in sugar.

 

 
The safest option is to not drink alcohol while breastfeeding. There is no known safe amount of alcohol to have when breastfeeding.

Alcohol can harm your baby’s growth and development, reduce your milk supply and the length of time you can breastfeed, and increase your baby’s risk of low blood sugar.  Drinking alcohol can affect your judgement and ability to care for your baby.

If you drink alcohol, limit your intake to reduce any impact on your baby’s health and development. 

Lower the risk:

  • Have no more than 1 alcoholic drink per day. 
  • Breastfeed before you have a drink.
  • Wait 2-3 hours per drink before breastfeeding or expressing your milk.
Discuss with your healthcare provider or call HealthLink BC at 8-1-1 for more information.‎
 

 

‎The safest choice is to not smoke or vape while breastfeeding. Smoking or vaping may impact your milk production and your baby’s growth and sleep.


It's best for your health and the baby's if you stop smoking, but if you do smoke you can still successfully breastfeed. Breastfeeding can help protect your baby from some of the negative effects of being exposed to tobacco smoke. 

Lower your baby’s risk:

  • Try to smoke less or use a nicotine patch.
  • Keep your home and car smoke-free.
  • Wash your hands and change your clothes after you smoke and before you hold your baby.
  • Practice safer sleep and avoid sharing a bed with your baby .
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Smoking, vaping or eating cannabis (marijuana, pot) while breastfeeding is not recommended. There is no known safe level of exposure when breastfeeding. Even second-hand smoke from cannabis may be unsafe. Cannabis passes into your breast milk and is stored in your baby’s fat cells and brain for weeks (up to 30 days). "Pumping and dumping" your breast milk does not protect your baby. The use of cannabis products may also affect your ability to care for your baby.

Breastfeeding is still the healthiest choice for your baby. If you are unable to stop using cannabis completely, lower the risks to you and your baby:
  • Discuss cannabis use with your healthcare provider.
  • Use less and less often.
  • Choose products with less THC.
  • Don't use cannabis with tobacco.
  • Use a vaporizer.
Find out more about using cannabis while parenting. 
 

 

‎Most medications such as pain relievers, antibiotics and antidepressant drugs are safe to use while breastfeeding. Medicine containing codeine, like Tylenol 3, can harm your baby. Talk to your healthcare provider or a pharmacist before taking any prescription or over-the-counter drugs while breastfeeding. 


Use caution with herbal or complementary medicine. The labels on these products do not always reflect all ingredients in the bottle and many of these products are not regulated by any Canadian government body.

 

 
Most methods of birth control are safe to use while breastfeeding. Some are more reliable than others. 

Options include:

  • Progestin-only birth control pills (oral mini pill)
  • The shot, such as Depo-Provera, which does not affect milk production
  • Barrier methods, such as condoms or diaphragms, used with spermicide or foam
  • An intrauterine device (IUD).
If you notice you have less milk after starting an oral contraceptive, talk to your health-care provider. Some people are affected by all birth control pills, even the mini pill, and their milk supply decreases. 

Lactation amenorrhea method (LAM) 

LAM refers to using breastfeeding as a method of birth control in the first 6 months. Many health-care providers recommend you also use another birth control method if you do not want to get pregnant. Ovulation occurs before your first period so you are at risk of becoming pregnant before your period restarts. Also, some women get their period before their baby is 6 months old. Talk to your care provider about birth control soon after birth if you do not want to get pregnant.

Find out more about breastfeeding as birth control.‎

 

 

‎You have the right to breastfeed anywhere at any time. Laws in British Columbia protect your right to breastfeed in any public area. You don't need to use a cover-up or blanket if you don't want to. You may feel more comfortable breastfeeding in public once you have practiced a few times.

Find out more about getting comfortable with breastfeeding in public.

 

 

‎The World Health Organization and Canadian Pediatric Society recommend that you breastfeed your baby for 2 years or more, or for as long as you and your baby want. It's recommended you breastfeed your baby exclusively for the first six months, and then start adding nutritious solid food while you continue to breastfeed.

Human milk provides all the nutrients your baby needs in the first six months – breastfeeding protects your baby from infection ​and illness, and promotes healthy development.

 

 
When to start weaning depends on how ready you and your baby are to stop breastfeeding. Gradual weaning is best. Look for signs your baby is ready to wean – your baby is no longer interested in feeding from your breast. Try dropping one feeding every five to seven days. This will help both you and your baby adjust and reduce the chance of your breasts becoming engorged. 

Learn more about weaning.‎
 

 
 

‎Many medical imaging tests, such as CT scans or x-ray procedures, require an injection of contrast media. Contrast media is a solution used to see blood vessels and organs like the heart, brain, liver, kidneys, and bowel. Contrast media is injected through a needle into a vein in your arm. The contrast media is naturally removed from your body through your urine (pee) within 11-24 hours. 


It is safe to continue breastfeeding after your test. The benefits of breastfeeding far outweigh the possible side effects to your baby.

If you have any questions or concerns, speak with your health care provider (physician, midwife, nurse practitioner, pharmacist nurse or technologist).

Learn more about breast milk and contrast media (PDF).

Common challenges

Breastfeeding can be challenging, especially in the beginning as you and your baby are getting to know each other. Knowing what to expect and what you can do to overcome challenges may help. 

If you are having trouble or feel discouraged, get help right away. Talk to your healthcare provider or call HealthLink BC at 8-1-1 for more information.

Common challenges

 

‎It’s common to have sore nipples during the first week of breastfeeding. To ease the pain, try expressing a few drops of colostrum (early breast milk) and massage it on your nipple . 


If your nipples have cracks, scabs, bleeding or blisters, it usually means your baby is not latching well. 

Some babies have trouble latching due to a recessed chin or tongue-tie. Sometimes sore nipples develop weeks or months later when your baby begins to teeth. Nipple soreness may also mean you have an infection. If you experience pain when your baby latches or are concerned about the health of your nipples or your baby’s ability to latch, speak with your healthcare provider, a nurse or a lactation consultant. 


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Your breasts may feel heavy, warm and uncomfortable, especially between 3 and 5 days after giving birth. Engorgement is normal as your milk supply builds to meet your baby’s needs. 

Tips to get relief:

  • Ensure your baby is well latched to the breast
  • Express a bit of milk by hand before you feed your baby
  • Feed your baby frequently, at least eight times in 24 hours or more
  • Avoid unnecessary supplemental feedings
  • Place cold compresses (cold packs or cold cabbage leaves) on your breasts before you feed
  • Take a shower or place warm wet washcloths on your breasts before feeding
Symptoms usually go away within a few days as your milk supply adjusts to your baby’s needs. You may find your breasts become engorged if you miss a feeding.

Get more information on breast engorgement.‎

 
Breast lumps are common during breastfeeding and are usually caused by milk collecting in your ducts (the channel your milk flows through). If you have a plugged duct, you may have a red, sore or firm area on your breasts. Plugged ducts usually go away within 1-2 days when treated, but can become infected.
To relieve and prevent plugged ducts:
  • Take a warm shower or place a warm cloth on your breasts before feeding.
  • Massage your breasts before feeding, especially behind the area with the lump.
  • Feed your baby frequently to empty your breast of milk (at least 8 times every 24 hours, including at night).
  • Position your baby with their nose or chin pointed to your sore spot. This position helps relieve the plugged duct.
  • Drain one breast completely before switching to your other breast.
  • Express your milk if your breast is still lumpy after feeding.

If the lump doesn’t go away in a few days, talk to your health care provider or call HealthLink BC at 8-1-1.

Read more about plugged milk ducts.

 

Mastitis is an infection of your breast tissue or milk ducts. Symptoms of mastitis include:

  • Hard, hot, red and sore breasts
  • A fever of 38 degrees Celsius or higher
  • Flu-like symptoms (chills and aches)

If you have these symptoms keep breastfeeding your baby and contact your doctor, midwife or community health nurse. Your health care provider may prescribe antibiotics to treat your mastitis. Antibiotics to treat mastitis are safe for you to take while breastfeeding.

Tips for breastfeeding with mastitis:
  • Breastfeed, express or pump at least 8 times every 24 hours.
  • Breastfeed on the sore side first, or if too sore, switch to the sore side as soon as your mature milk starts to flow.
  • Position your baby with their nose or chin pointed to the sore area. This position helps relieve the plugged duct.
  • Take a warm shower, bath or put warm cloths on your breasts.
  • Gently massage above and over the tender area of your breast towards your nipple.
  • Combine hand expressing and single and double pumping if it is too painful to breastfeed.
  • Hand express after breastfeeding until your milk stops flowing and your breasts are soft.
  • Use cold gel packs or ice to decrease swelling.

To help prevent mastitis, ensure your baby is well latched when breastfeeding or express your milk regularly.

Read more about mastitis while breastfeeding.‎

 
If your nipples itch or burn, or if you notice a rash on your areola (coloured area around your nipple), you may have a yeast infection (thrush). You may be at higher risk of developing thrush if you or your baby took antibiotics recently, your nipples are cracked, you are taking oral contraceptives (birth control pills) or you are on asthma medication. 

A yeast infection can affect your baby – look for white patches in your baby’s mouth or a red rash in your baby’s diaper area. If you baby is infected, they may refuse to breastfeed, be gassy, cranky or gain weight more slowly.

Contact your health care provider right away if you have concerns about yeast infection and to discuss a treatment plan. It is important that you and your baby are treated at the same time. Your partner may also need to be treated.

Preventing and coping with a yeast infection:
  • Wash your hands frequently.
  • Wash your bras daily.
  • Keep your nipples dry.
  • Disinfect your breastfeeding equipment after every use.
  • Ask your healthcare provider about taking probiotics.
  • Avoid giving your baby soothers, or boil soothers for 5-10 minutes daily. Replace often.

Learn more about coping with a yeast infection when you are breastfeeding.

 

If your nipples don’t stick out or they sink in when stimulated, it may take your baby longer to learn to latch onto your breast.

Things you can try:
  • Roll your nipple with your fingers before feeding
  • Use a breast pump on a low setting to draw your nipple out

If you baby is having trouble latching or feeding well, discuss your concerns with your healthcare provider.

Using a nipple shield‎

A nipple shield is a nipple-shaped covering worn over the nipple during breastfeeding to help a baby feed. A shield may be helpful if you have flat or inverted nipples or your baby has trouble latching.

Using a nipple shield​ ​(PDF).

 

 

‎It’s common to worry about making enough milk to feed your baby. Most mothers are able to produce all the milk their baby needs. If your baby is content after feeding, alert and active at other times and growing well, your baby is likely getting enough milk. 


If your baby loses more than 10% of their weight in the first few days after birth or if you have concerns about your milk supply, talk to your healthcare provider or call Healthlink BC at 8-1-1 to speak with a nurse.

Visit how to breastfeed for information on increasing your milk supply and signs your baby is feeding well.


 
Newborn babies have extra red blood cells. As those cells break down, a yellow substance called bilirubin is released. Bilirubin in a baby's blood causes the skin and the whites of the eyes to take on a yellowish tinge called jaundice. It’s common for your baby to develop jaundice during the first week after birth. Jaundice usually lasts a few days. 

Things you can do to help your baby:

  • Breastfeed your baby 8 or more times in 24 hours using breast compression and massage. This helps your baby get more milk.
  • Express your breast milk and give it to your baby if your baby is too sleepy to feed
Regular feeding or giving your baby breast milk may help your baby get rid of the bilirubin through their stool (poop). Talk to your healthcare provider if you are concerned that your baby has jaundice.

Find out more about jaundice and your newborn.


Getting help

Get help right away if you notice any of these signs:

Your baby:
  • Has trouble breathing. For example:
    • Fast breathing (more than 60 breaths in a minute)
    • Moaning or making wheezy sounds
  • Has a fever of 37.8 ° Celsius or 100.4° Fahrenheit or more
  • Has a temperature below 36° Celsius  or 97° Fahrenheit after warming for at least one hour with skin-to-skin cuddling, warm blankets or extra clothing
  • Vomits forcefully several times. This does not include small amounts of spitting up following a feeding
  • Has green mucus spit-up
  • Feeds less than 8 times in 24 hours (PSBC breastfeeding chart)
  • Has black or dark coloured stools (poop) after day 4 (72 hours after birth)
  • Has less than 3 stools (poops) or fewer than 6 wet diapers in 24 hours
  • Is unusually sleepy, fussy or restless
You:
  • Get help right away if you feel like you have the flu
  • Talk to your healthcare provider if you notice these signs in your body: 
    • Your nipples hurt
    • Your breasts feel hard and painful

Getting help with breastfeeding

Learning to breastfeed can take time. Practice, patience and support can help you reach your breastfeeding goals. Reach out to someone you trust if you are having trouble or feel discouraged. There are community resources available to help you.

Discuss your breastfeeding questions and concerns with your community health nurse, midwife or healthcare provider.

Check out the list of community resources on the right side of this page.

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